Provider Demographics
NPI:1922768209
Name:SPURLOCK, ANGELA (CRNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:SPURLOCK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:SPURLOCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:4070 THOMPSONDALE RD
Mailing Address - Street 2:
Mailing Address - City:COOPERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18036-9760
Mailing Address - Country:US
Mailing Address - Phone:610-217-1133
Mailing Address - Fax:
Practice Address - Street 1:1700 ST LUKES BLVD STE 200
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-5670
Practice Address - Country:US
Practice Address - Phone:484-526-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024918363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily